Provider Demographics
NPI:1942852223
Name:GOOD INTENTIONS SUPPORT SERVICES,LLC
Entity Type:Organization
Organization Name:GOOD INTENTIONS SUPPORT SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-504-2379
Mailing Address - Street 1:7170 THREADSTONE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1857
Mailing Address - Country:US
Mailing Address - Phone:917-504-2379
Mailing Address - Fax:
Practice Address - Street 1:1732 JULIAN LANE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-5550
Practice Address - Country:US
Practice Address - Phone:917-504-2379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management